Quick Pen-and-Paper Test Can Spot Signs of Dementia

Below:

Next story in Science

Results of a pen-and-paper test can alert older adults to a need
to be evaluated for dementia, according to a new study.

The self-administered test, which requires about 10 to 15 minutes
to complete, is designed to be a quick
screening tool for dementia that can be taken in virtually
any setting, including at home or at community events.

People who miss six or more points on the 22-point test — which
evaluates language skills, memory and problem solving abilities,
among other cognitive functions — may have cognitive problems,
the researchers said. A person's test result could prompt their
doctor to conduct further tests to understand what is behind
these problems, they said. [ 10
Ways to Keep Your Mind Sharp ]

In the new study, about 1,000 people ages 50 and older took the
test at community events such as health fairs, and 28 percent
were identified as having
cognitive problems. All participants were encouraged to share
the results with their physician for interpretation.

The researchers stressed that the test cannot diagnose dementia
or Alzheimer's disease, but rather is intended to start a
conversation between patients and their doctors. Potentially,
such a discussion and subsequent evaluation could catch dementia
in its early stages, leading to better management and treatment
of the condition, said study researcher Dr. Douglas Scharre, a
neurologist at The Ohio State University Wexner Medical Center.

Scharre noted that many people with dementia are not diagnosed
until three or four years after their symptoms start. "The big
problem in dementia and Alzheimer's care is that individuals are
just identified too late," he said.

While there is no cure for Alzheimer's
disease, some treatments do exist, and studies show patients
who start treatment earlier progress more slowly in their
disease, Scharre said. In addition, it is important to identify
dementia because people with the condition may need to be
supervised to prevent dangerous situations, such as when they
forget to take their medication, he said.

While other tests exist to screen for dementia, many require a
doctor to administer them. Because of the time it takes to
administer such tests, it is often not feasible for doctors to
screen all of their older patients for dementia, and they may not
notice subtle cognitive changes in their older patients during
office visits, the researchers said.

This problem prompted Scharre and colleagues to develop the
Self-Administered Gerocognitive Examination (SAGE), as the new
test is called. An earlier study found the test detected 80
percent of people with mild thinking and memory issues, while 95
percent of those with normal thinking abilities had normal
scores.

Providing the SAGE test at health fairs or other community events
could perhaps get people to visit the doctor who otherwise would
not have, Scharre said. People could also take the test over
several years, and a change in their score may indicate a change
in cognitive abilities.

Future research

However, there is no proof that the SAGE test actually does
identify patients in the early stages of dementia, a question the
researchers hope to tackle with future studies. In the current
study, participants who took the test at community events were
not followed to see if they spoke with their doctor about the
results, Scharre said.

Other experts were supportive of the idea behind the test. "I
think that any test that improves detection of dementia is
useful, because dementia is so under-recognized," said Dr.
Gayatri Devi, an attending neurologist at Lenox Hill Hospital in
New York. About 50 percent of patients with moderate dementia and
90 percent with mild dementia are not recognized by their general
practitioner, Devi said.

But SAGE and other similar tests take time to be validated by
researchers. "This kind of test needs more time before we can
really be sure that it's a good, valid test," Devi said.

The study is published in the January issue of The Journal of
Neuropsychiatry and Clinical Neurosciences.